Diagnosis of Carpal Tunnel Syndrome

Carpal Tunnel Diagnosis

CTS is known to cause unpleasantness and even pain that can originate in the fingers and expand to the entire arm if untreated. While the most common ways of treating CTS are based on nonsteroidal anti-inflammatory drugs or, in the early stages, immobilization of the wrist, scientists still don’t know what exactly causes CTS.

The main problem occurs when one of the main nerves in hand — the median nerve — gets compressed or damaged. This can cause multiple problems and even severe pain. Furthermore, the main reason this can happen is that the nerve is going through a tunnel in the carpal part of the wrist. Even though it is the only nerve in there, nine tendons go through the same tunnel.

Finally, wrist pain caused by CTS can evolve into serious numbness and discomfort in the entire hand, which can only be treated through surgery.

Symptoms of CTS

Pressure on the median nerve will initially cause numbness, a feeling similar to electric shock, and eventually pain. Since the nerve we’re referring to is in charge of sensation in all fingers but the pinky, the pain and all other symptoms will originate there as well. 

During the early stages, the problems will appear mostly during the night, but will eventually start showing throughout the day too. Besides, most of the issues can be seen during regular activities like holding the phone, or a glass, or anything else. The person suffering from CTS will feel his grip weaken, and may even notice clumsiness during regular activities.

Because the nerve is pressured (either from the inside or from the outside of the tunnel), there will also be limited mobility, or more likely, reduced mobility if the condition progresses.

Diagnostics

While most of the symptoms can be spotted easily, the real tests and confirmation are not as simple. If you confront your doctor with this issue, he will have to perform several tests to determine if CTS is the reason for the hand pain and other symptoms.

  • Patient History — Since pain and all the sensation controlled by the median nerve are limited to all fingers but pinky, any other problems that occur on the little finger might mean that the problem is not related to this specific nerve.
  • X-ray — While x-ray can’t really detect CTS, it will undoubtedly rule out other potential causes of pain in the joints like arthritis or a fracture. This way, doctors can proceed to other tests. 
  • Electromyogram — During this test, doctors will insert needles in the specific tissue in order to measure the electrical discharge in muscles. The test is done when muscle rests and when it contracts. The results will show if there is any damage, and even rule out several different conditions.
  • Nerve conduction study — While this test is a variation of electromyogram, it is used for a different purpose. This time, the doctor will measure impulse going through the median nerve. By sending a small shock and measuring the results, they will be able to see if the impulses were slowed while passing through the carpal tunnel. Not only could this confirm CST, but it can also eliminate several other conditions.
  • Physical examination — As you can imagine, this is one of the easiest tests, where the doctor will measure and check the feeling in fingers, the strength of the grip, and other. Interestingly, pressing the nerve or tapping it might cause the symptoms in some cases.